Measles, What To Do?
By Evan L. Lipkis MD
I have been getting loads of questions on the recent measles outbreak. According to the CDC, there are already more cases of measles in U.S. from January 1st through April 4th, 2019 than in 2018. More details about this outbreak can be seen at www.cdc.gov/measles/cases-outbreaks.html
What are the symptoms?
Symptoms include the 3 C’s: cough, coryza (runny nose) and conjunctivitis. The rash usually begins on the face and spreads. In areas with low immunization rates, 9 out of 10 unimmunized people exposed to the virus will acquire this highly contagious disease.
Are vaccines safe?
Vaccines are very safe agents and numerous studies show MMR (measles-mumps-rubella) and other vaccines DO NOT cause autism. https://annals.org/aim/article-abstract/2727726/measles-mumps-rubella-vaccination-autism-nationwide-cohort-study
However, one in 1,000 patients who get measles will die from encephalitis or brain infection.
Giving multiple vaccines according to the recommended schedule will not overwhelm the immune system and vaccines remain one of the most successful and effective medical innovations of the 20th century.
Getting vaccinated builds trust. We help ourselves and help each other by maintaining immunity in our community. I like the sound of that.
Who should be vaccinated?
Children receive two doses of MMR (measles, mumps, rubella) at 12-15 months and then again at 4-6 years of age.
If you are traveling to an outbreak area or anywhere outside the U.S., then kids 12 months or older should have two MMR doses at least 4 weeks apart or one MMR dose for infants 6 to 11 months.
But if infants get an MMR before one year of age, they still need two MORE doses per the above schedule instead of just two doses total.
Adults born in 1957 or later need at least one MMR vaccination. The MMR vaccine was first introduced in 1971. Certain adults born after 1957 who are at higher risk and not previously vaccinated should have 2 MMR doses at least 4 weeks apart. Higher risk groups include college students, healthcare workers, active military personnel and international travelers.
For people born after 1957 and without a record of receiving an MMR, then get vaccinated one time unless you are in one of the above groups.
The inactivated vaccine given in the 1960s, was largely ineffective. The MMR is a live vaccine, so severely immunocompromised or pregnant patients shouldn’t receive it. But their household contacts should be up to date regarding their vaccinations.
Since measles was an epidemic before 1957, those born before that time are assumed to be immune. The CDC didn’t recommend testing for measles, but this can easily be accomplished. It is estimated that 98% of this group are indeed immune.
Should we get a booster?
During the current outbreak, we are supposed to follow our local health department's advice. So far, MMR boosters aren't recommended during the current measles outbreak if you have already been adequately vaccinated.
About 97% of people develop lifelong immunity after two doses of the measles vaccine. This differs from mumps where immunity can wane over time.
Doctor’s RX: Measles is a highly contagious disease. While the most recent outbreak is small, cautions should be taken. Routine vaccination is very effective and quite safe. Booster shots have not been recommended by the Department of Health but stay alert. For more information see www.cdc.gov/measles/hcp/index.html
Evan L. Lipkis MD